Background: Puberty is the growth process associated with appearance of both primary and secondary sexual characteristics in children. Delayed puberty is defined clinically by the absence or incomplete development of secondary sexual characteristics bounded by an age at which 95 percent of children of that sex and culture have initiated sexual maturation.

Methods: Some of the children participants were already being followed for constitutional delay in growth and puberty for long periods by our colleagues at ours institutions. The initial evaluation of delayed puberty should consist of a complete history and physical, basic laboratory tests to look for signs of chronic disease, and hormone level tests. These measurements are used to calculate linear height velocities and establish a trajectory on the growth curve.

Results: Puberty may also considered to be delayed in girls if the whole process isnt complete in four years or five years for boys or if menarche hasnt occured by age sixteen. Family history is often positive for siblings or parents with delayed puberty. Puberty delayed but begins before sixteen years in girls and eighteen years in boys in Bosnia and Herzegovina.

Discussion: Children with a constitutional delay in beginning puberty in beginning puberty usually do not require treatment and they will eventually begin puberty and then progress through the stages of puberty normally.

Conclusions: More then 250 causes of delayed puberty in boys and girls, including diseases and drug side effect cause this diseases in Bosnia and Herzegovina. Tanner staging method was considered critical to the collection of puberty-timing data, but inclusion of breast tissue palpation and testicular volume assessment was recommended to increase the reliability of estimating the ages of breast and genital development onset.